Jessie Rosanne Smith, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.013667 Issued in IL

Practice address

3778 N Meridian Rd
Olney, IL 62450-4815

Phone

(618) 839-4871

NPI assigned

Nov 1, 2012

Last updated

Nov 1, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

County of ClayGroup PAC ID 0042101982, 77 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• County of Clay

  dba CCH Medical Clinic

  • Rural Health Clinic/Center
  • Flora, IL
  • NPI 1811946411
  Medicare reassignment Care Compare group NPD
• County of Clay

  dba Clay County Hospital

  • Critical Access Hospital
  • Flora, IL
  • NPI 1184655136
  NPD
• County of Clay

  dba CCH Pharmacy

  • Community/Retail Pharmacy
  • Flora, IL
  • NPI 1235990276
  NPD
• County of Clay

  • Rural Health Clinic/Center
  • Clay City, IL
  • NPI 1871950550
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1351728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351728000000",
    "number": "1063766830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3778 N MERIDIAN RD",
            "city": "OLNEY",
            "state": "IL",
            "postal_code": "624504815",
            "telephone_number": "618-839-4871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3778 N MERIDIAN RD",
            "city": "OLNEY",
            "state": "IL",
            "postal_code": "624504815",
            "telephone_number": "618-839-4871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JESSIE",
        "middle_name": "ROSANNE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-01",
        "last_updated": "2012-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.013667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yanci J Shroyer, PMHNP
• Tamara Marie Slankard, OT
• Jessica Slater
• Arrah Slichenmyer
• Emily C Smith
• Kayla Smith
• Robert Snow
• Solstice Emergency Physicians, LLC
• South Eastern Illinois Counseling Center Inc
• South Eastern Illinois Counseling Center Inc

• Clinical Social Worker in Olney, IL
• Providers in Olney, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.